Metabolic disturbances and arterial hypertension in pregnancy: short- and long-term effects on mother and fetus

Abstract

Fpidemiology studies have confirmed a hypothesis on pre-natal risk determination for metabolic syndrome (MS), arterial hypertension (AH), and coronary heart disease (CHD). Gestational diabetes (GD) and obesity are typical metabolic disturbances in pregnancy. Insulin resistance (IR) development at early gestation stages results in fat tissue proliferation and increased feto-placental nutritious value by late pregnancy stages, when fetus weight increases by 70%. Increased IR in mother provides reproductive benefit in case of under-nutrition and over-working, at the same time being able to result in GD, when combined with calorie-rich diet and sedentary lifestyle. Increased IR and pre-conception obesity increase macrosomia and fetus overweight risk. Overweight children of GD mothers have increased risk of juvenile obesity and type 2 diabetes mellitus (DM-2). Decreased fetal height and body size in pregnancy and early post-natal period could also result in DM and MS later in life. In spite of low cardiovascular morbidity in young women, gestational hyperglycemia combined with pre-pregnancy obesity, as well as gestational hypertensive syndrome, significantly increase cardiovascular risk. Women with pregnancy-diagnosed metabolic disturbances and AH, as well as their children, need to be actively followed-up and treated, if necessary.

Keywords

• arterial hypertension
• pregnancy
• metabolic disturbances
• insulin resistance